CAn anyone help me better understand my birth experience?

[morelovetogive]

I had a rubbish birth experience and it has taken me quite a while to come to terms with things. In the end i requested my notes and now have a better understanding of what happened. I just would like other peoples opinions on what happened to me, i don't think i will get any more answers from the professionals.

I planned a lovely home waterbirth but it wasn't to be. Was told baby was too big and was happy to err on the side of caution and go in to hospital. In the end my waters were trickling so had to go in anyway. Had a s&s and was sent home to return next morning for induction of nothing happened. Labour started overnight. Went in next morning and thoroughly enjoyed early labour in the bath with gas and air and lovely midwife. Unfortunately was told wasn't progressing fast enough so had to have drip to speed up contractions. Very reluctantly agreed to that and diamorphine. Contractions then came one on top of the other for some time so ended up with an epidural as i wasn't coping and had been in labour for about 10 hours by now. Progressed to 7cms but no further. EMCS followed. During this they found i had an obstructed labour, a constriction band??? What causes this??

Then as DD was born the incision in my uterus extended further, the main artery as damaged and i lost 3.5ltrs of blood, which wasn't at the hospital and it was snowing heavily so took some time to arrive. I was told afterwards i very nearly bled to death.
Has this heppened to anyone else?

I was told afterwards that i shouldn't have any more children as my uterus would probably rupture due to being structurally weak. Anyone else been told this? A consultant said i could have more but would have to be a csection early. Have decided not to take the risk but just wondered exactly how risky it really would be.

Any thoughts, opinions etc would be appreciated.

Thanks

I also had pressure sores after 3 hrs on theatre table, now healed fine. I presme that was caused by my bp dropping so low for so long (80/40).

My uterus was also stuck to my bladder dua to extensive endo which contributed to problems.

Feel very guilty for not giving my daughter a better birth and not holding her til she was 4 hrs old. Then being totally unable to care for her for a couple of days. She was fine throughout btw.

Not sure but didn't want your post to go unanswered. I'm sure there'll soon be MNers who can give more insight.

I'm sorry you had such a difficult and painful birth experience which nearly ended so tragically. I'm glad to hear your daughter was fine and you're recovering. Please try not to feel guilty for anything!! Maybe you can see your GP for counselling to move on, I'm sure you'd qualify for that.

Have you ever gone back to the consultant you had and discussed the event again? Could you do this?

No expert or anything here.

Firstly, you have nothing to feel guilty about ok?

You may have regrets, doubts about your ability to birth, wishes for things to have been different, etc. these are all normal, from what i've read of others/my own experiences.

I would say that you really do need to get more opinions about the possible risk for future pgs/births, one person's opinion is not enough.

When you got your notes, did you have anyone talk through things with you? maybe contact PALS for more help there.

But mainly, congratulations on your DD

sorry to see your post. you say that you got all the answers from the professionals, but clearly not. maybe try again with a different birth counsellor- the one who sits and goes through your notes with you. even if you've done it before, so what. its no crime to later have further questions.
write all q's down, now. explain that you want to have another child but are too frightened becasue you don't undestand the implications.
good luck.

Good grief, please don't feel guilty for "not giving my daughter a better birth" - you did a fabulous job giving birth and being able to care for her after that - none of us remember our journey into the world and she certainly won't, what's important is for you to find your peace with it. I had a traumatic birth experience (for me - nowhere near what you went through) and it was only when I spoke to a lovely midwife during pg2, wheh she went through my notes and did a de-brief, that I came to terms with what happened and understood it all. I second oblomov's advice, do try again to go through your notes with all your questions ready and if possible, have a friend/DP/mum/sis with you for support - if they are also prepped to ask the questions for you if you are unable, that will help, but they could focus on writing down answers for you, so you can listen properly without worrying about writing everything too.

How old is DD now and how is your relationship with her? you sound like a lovely mummy to be so worried about her experience of the birth.

Women like yourself who have been through so much to bring your child into the world should really be so proud for doing what you've done.

Not sure this is much help but you asked if anyone has nearly bled to death. Not me but a good friend had a 'successful' natural delivery but then started bleeding - basically the placenta wound wouldn't clot and heal and she ended up with 9 litres of blood put through her - i.e. more than 2 bodies worth. To stop the bleeding they had to give her an emergency hysterectomy.

After I had my ectopic (only one litre of blood and a fallopian tube lost) she told me her story and said that she was offered councilling (sp?) it might be worth asking if this isn't being offered to you...

First of all, absolutely none of what happened is your fault.

We often go into labour not really knowing what can happen or develop. I certainly didn't. And it's can be really bl**dy frightening. And it can stay with you for a long time.

It's important that you talk to counsellor to go through your experience because I think it would shake up anyone. If you think it would help, then do talk to someone. There's this organisation or your G.P.

As for your uterus being structurally weak, well, who knows? I'd get a few opinions on that. Consultants err on the side of caution when it comes to vaginal births after caesarian births regardless how straightforward the C-section was. You can't blame them really because they tend to only see difficult birth situations.

You could consider going through your notes with an independant midwife who could give you an alternative unbiased view.
It does sound like a very difficult birth experience.
Was your baby large?
It sounds like your baby could have been posterior or malpresenting, signs include waters breaking at the staet of lkabour, contractions coming and going and slow labour.
Did they mention Bandel's ring (the constriction band)
More info here-
womantowomancbe.wordpress.com/2009/11/03/bandls-ring/
If it was this there is conflicting advice about whether it reoccurs or not.
It does not usually occur because of uterine weakness, but long, obstructed labours with malpresenting babies or adhesions due to previous surgery of endometreosis.
If you wanted to try for a VBAC, you would probably be supported to do so in hospital.
HTH
Selina x

well for a start your labour sounds a bit mis-managed,I wonder why they speeded it up? did they give a good reason? I do know someone who had very serious bleeding,she had retained part of her placenta.I collapsed after my c-section and it was crash team/all hands on deck terrifying,I could hear them calling my name as I ws coming round but I couldn't reply.They think I had lost more blood than had been thought initially so I had to have blood i/v.It was very traumatic,so I sympathise deeply.
My thoughts are this:
1.labour was too fast.You need to know why this was. 2.You sustained some damage during the surgery.Was this because of the endo?
3.What happens now.? you haven't been given much clear information or support.Could you pay for a one off private consultation with someone who would talk you through this? A really good obstetrician? It wouldn't be hideously expensive and I think you need clear answers especially as you've been given conflicting advice about a second pregnancy.
3.Don't feel guilty.Feel sad for yourself,yes,and for your baby ,for not having the birth you wanted,but please don't feel guilty,you have nothing to feel guilty about.
4 I really hope you get some answers.x

Hi sorry to hear about your birth experience but I just want to echo what other posters have said, DO NOT FEEL GUILTY!!

I was in a similar, although less horrendous experience than you. I had a natural very quick delivery with big baby (9lb6oz) and big placenta. Then my uterus collapsed and just would not contract, fortunately I was completely oblivious to the severity due to the gas and air. I lost 3.5L, had 2 units transfused, went to theatre for 3 hours to be packed with balloon, and DP and mum were spoke to about the possibility of hysterectomy but fortunately that wasn't the case.

I too didn't get to hold DD until 4 hours later but rather than feel guilty I am just so grateful that we are both safe and that DD1 and DD2 are both here and that I am here with them and DP wasn't left alone. Just enjoy your beautiful daughter!

For every post natal check DD2 or I have had the GP/HV/MW have all said, oh you're a lucky girl which kinda drives home that I am and that's how you should look at it too. I would definitely speak to your HV if you feel really upset as previously said you could speaak to someone.

On a side note in the midst of all the madness just before going to theatre the doctor who was placing the oxygen mask over my face said to me, no more babies for you. Since then every other health professional has said it would be possible but there would be a managed 3rd stage. So if you are looking to have more children in future then I'd definitely get a second opinion.

I hope some of this helps.

Lola! what a dreadful thing for someone to say to you before putting the mask over your face-I am shocked,that is like some awful nightmare!

What a horrible experience for you - and very much not as you'd hoped and planned, which makes things hard.
I would agree that you need to get a second opinion - perhaps more than one - on the safety of another baby before making any firm decisions (always assuming that this is the major factor in your decision!). It sounds like it isn't straightforward so I suspect what you need is the opinion of the consultant involved in the surgery and possibly a further consultant who has access to your notes. Perhaps it would be useful for you to meet with the consultant in charge of your care anyway - it sounds like you still have a lot of unanswered questions and you deserve the best answers possible to help you come to terms with this. If healthcare professionals haven't given you answers yet, keep asking - there may be no answers eg why did this happen - but they should at least explain that to you. One question that springs to my mind is why wasn't the blood on site - if they are taking people to theatre they should at least have O negative blood there and I would have thought facilities for providing cross matched blood also.
From a more personal point of view - I too had a fairly disastrous delivery - normal pregnancy and labour then developed group B strep sepsis so emergency section, DIC so blood not clotting and 7 litre PPH - received around 20 units of blood / blood products. I found it absolutely terrifying - even understanding everything that was going on (I'm a doctor) it just made me realise how close I came to not making it. Again, despite understanding it all I felt very guilty for not giving my daughter a better start in life - born unwell and needing scbu rather than straight into my arms for the breast feed I'd imagined - and all because I'd developed an infection. The logical part of my mind could see that feeling guilty was utterly crackers - but birth and motherhood is such an emotional experience that I felt it anyway.
I hope you get some answers. Please don't give up until you do. Unfortunately the NHS can be fairly rubbish at providing aftercare (when I requested counselling when my little girl was 14 weeks old I was told that post-delivery counselling was only available up to 12 weeks after the birth!) - so keep persisting till you get what you need. If you have a sympathetic GP they can be a fairly effective advocate (I am a GP now so somewhat biased - but this is the kind of situation where I would gladly get involved both to support you and to try and get info for you).

There's some information on Bandl's rings here, think its explained quite well.

www.babyworld.co.uk/faq/individualfaq.asp?Section=Labour+and+Birth&SubSection=Labour&query=&opt=&pag e=&question=2596

It sounds like your baby was probably in a bad position to come down the birth canal. Its not always possible to realise this at first but that could be why you eren't dilating. Then the drip was put up and your body was being forced to try and do something it couldn't do.

Sometimes there are complications in theatre and women can bleed a lot. I'm guessing that they probably did have emergency o-neg blood and that you would have been given that while waiting for the other x-matched blood to come. It is odd that they didn't have any of your type at the hospital, do you have rare anti-bodies?

As for the risk of another pregnancy. Off the top of my head I think the risk of a scar rupture for a normal lscs scar in a subsequent pregnancy is 0.4%. I'm guessing that a larger/more unusual positioned scar will have a bigger chance but n sure how much. It would depend on how bigand where the cut extended to. Your consultant should be able to give you some idea of % risk. I know in countries where they still do classical incisions (vertical) there is a higher risk of scar rupture. Saying that I've seen ladies who have had a classical incision go on to have healthy pregnancies with no problems.

Thank-you very much for all your responses. To try to answer the questions;

DD is 6 months old now.

Yes she was a big baby but not huge at 8lb12oz. Her shoulders were stuck on my notes it says she was posterior shoulder dystocia. They struggled to get her out hence (i'm assuming the extra damage) There was a definite atmosphere in theatre though and undertones from other staff that they blamed the registrar performing the surgery for what happened. For quite some time everyone was stood around looking worried but doing nothing while they wated for the consultant on call to get there, he took a long time because of the snow.

Despite labour being speeded up by the drip it was still a long labour. I began having contractions not long after s&s at aroun 7pm went to hopsital next morning and was 2cms at 8.30am but dd wasn't actually born until 3.59am the following morning.

I am A neg blood type so reasonably rare. I was given uncrossmatched o neg in the end and my blood didn't arrive until i was in recovery.

I don't think i can pursue this further in terms of councelling or speaking to consultant to be honest. Partly because it has taken me a long time to be this ok with it all and partly because OH has said absolutely no way will he risk losing me again and when i have talked about seeing someone in the past he thinks it is because i want to find out about having another. To be honest i have told everyone around me i can't have anymore and have found it very difficult. I did want more and don't want to miss out because of misinformation but equally i don't know that i dare risk going through that again. I honestly thought i was going to die, infact i had accepted that i was and was laid there trying to think of a message for DH to give DD but didn't want to say it incase i upsed DH who was putting on a brave face for me. He was there throughout and was probably more tramatised than i was.

The guilt i think comes from the fact that i can't help but wonder whether things would have been ifferent if i'd not had the s&s, refused the drip, not had diamorphine or epidural. I feel a strong sense of failure over it all. My birth plan said i didn't want any artificial augmentation if it could be avoided. They said i had to have the drip because waters had begun trickling over 24hrs previous. I know i could have refused this but i didn't and i don't know why. Probably would have all ended the same i know but i do wonder. I feel like i have been robbed of that magical moment when my daughter emerged, holding her for the first time. Instead once i had seen she was ok i asked for her to be taken away because i couldn't keep my eyes open or focs my vision on her and i felt so sleepy. I often think about the fact that if i had died i wold never have held her. Then i had to watch other people do all of the things i should have been doing. Midwives helping her clear the mucus from her chest, my DH dressing and changing her. It was weeks before i felt i could be a proper mother to her and do all the things i should have been doing.

Our relationship now is wonderful. I love her more than i thought possible and it is for that reason that i think i will just accept that having more children is too risky. I couldn't bear the thought of her growing up without me. She has a wonderful daddy too but i want to be there to watch her grow up and she deserves to have both her mummy and daddy there.

From what i understand of my notes the scar on my uterus extends left to right and also front to back where it tore. There is also the additional scaring and damage caused by the adhesions to my bladder.

So very very saddened to read your last post. i had 2 emcs and feel great about them, so cant relate. but one of my closest friends with 2 children exactly the same age as me - 6 and 1.5 had terrible terrible birth. took her years of reviewing notes, and counselling to get over before she was able to have 2nd child.
please , you say, "I don't think i can pursue this further in terms of councelling or speaking to consultant to be honest.", please please this is the very thing YOU NEED TO DO. maybe not now because you are too raw. dd is only 6 months so this maybe too soon. but you poor darling, you do need support and counselling. and if you reviewed the notes with dh, in time, just maybe you would be able to consider that 2nd child. because that is what you want deep in your heart. and as your name suggests, you have so much more love to give. don't deny your dd, or more so yourself. please, please.
i as a diabetic of 35 years had incredibly easy births, but quite hard pregnancies. but my heart bleeds, no pun intended for poor births like yours. you are traumatised and scarred. rightly so.
please let others, proffesionals and Mn'ers help you. we are good at this.

Hi. I can see that dh must be petrified of losing you...but still think it's important to talk it through this awful experience (and the implications) with someone professional - I think together. This A counsellor won't be an expert in your specific birth issues, but could help you both heal over that very traumatic situation. I think it's really important to do that, because any residual guilt or grief can affect the way you respond to your dd (not in terms of bonding, but - possibly- compensating or being fearful of letting her take risks etc). What you're doing, coming on Mumsnet, is a great first step in dealing with this. Try and reassure dh that it's really not about another child right now, but just about getting over this. It sounds like he needs to as well, not surprising with what he went through as well.

I know I've said it's not about having another child...but one question regarding that. If a rupture was a possibility second time around, would it be possible to have an immediate hysterectomy (like someone else on here) and if so, what are the risks? That's a question I would ask IF you ever decide that you would like more.

Although my severely traumatic birth was different to yours several things you say do resonate (particularly the fact that you were not the first to hold your dd and that you then could not care for her for a while).

I understand that you do not want to talk through this again with the hospital, too. There is always an element of them holding information back from you; you will never get the whole truth.

All I can say is that the trauma eases off and eventually almost goes and at some point you will be able to go days even weeks without even thinking about your dd's birth. It might help you to try and just accept it for what it was, go through the usual stages of trauma, and live with it thereafter.

Sorry I cannot be more helpful.

bibbitybobbity that is exactly how i feel. I'm not sure what i hoped to get out of this post but i do think it has been helpful to have other peoples perspective on things. I have spent the last few months trying to simply accept what happened and have started to think about it less.

The thing that helps most is that i am choosing to view this as something that was meant to happen. It has given me a new perspective on life and also means that we have room in our life and hearts now that will enable us to help other children in the future. When we are ready we will be applying to become foster carers, something we have talked about often in the past.

Thank-you for sharing your experiences and thoughts with me. I will practice thinking abot how amazing it is that my body grew a baby and with a little help delivered it safely into the world and hopefully those thoughts will become stronger than the negative memories.

Don't ever rule out seeing somebody to talk it over. I had a traumatic delivery and can fully understand the feelings of guilt, the what ifs, the anger, the disappointment, the regret at not being able to hold and care for your baby straightaway.

3 days before my dd turned 3 I saw a consultant who specialises in birth trauma. I had my notes, I knew them off by heart but he told me things I just didn't realise. I wasn't able to discuss it for 3 years. That appointment was the beginning of things turning around. He has since written to me to offer to be my consultant if I have another, outlined in detail (4 pages) what he thinks would happen next time (in terms of care and options), how he would manage it etc. I feel in control for the first time in years. I haven't had a panic attack since the meeting or a nightmare and they were daily occurences.

The option is always there.

You did nothing wrong. Fate dealt you a tough hand.

It's taken me a long time to accept that I did not fail my dd. You will accept it too I hope.

I just wanted to come back and update on this. Last week i went for a debrief with a consultant and my midwife. I know fully understand what happened to me and why which is good. Unfortunately the damage to my uterus was so extensive that they are unable to quantify the risk of rupture during pregnancy or c-section. My scar extends approx 2/3 of the way around my uterus, incorporating where the uterine artery joins, plus the vertical scar from the 't' cut. As a result we have decided the risks are potentially to high for us to take the risk and we are sticking by our original decision to not have any more children . I am now considering asking for counselling to help me feel better about the birth and to deal with the flash backs which are less frequent but still happen.

Thank-you for your comments here which helped me to feel justified in wanting a debrief this long after the birth. It was definitely the right thing to do.

Morelove, have read this thread because of my own, still sad feelings about my DD2's birth. The circumstances were nowhere near as clinically severe, however I was greatly helped by contacting Sheila Kitzinger via Birth Crisis. Something I would not have done without the suggestions of others on this board.